"Graded Cycling Test with Talk Test" Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke

Rikke Steen Krawcyk; Anders Vinther; Nicolas Caesar Petersen; Christina Kruuse

doi:10.1016/j.jstrokecerebrovasdis.2016.12.004

"Graded Cycling Test with Talk Test" Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke

Rikke Steen Krawcyk, Anders Vinther, Nicolas Caesar Petersen, Christina Kruuse

Department of Clinical Medicine

4 Citations (Scopus)

Abstract

BACKGROUND: Physical exercise is generally recommended as part of life style changes post stroke. Monitoring cardiovascular effects may help motivate patients for further exercise, and can be an instrument to assess intervention effects in clinical trials. In 1 of 4 stroke patients, the heart rate variability may challenge currently used cardiovascular monitoring. The Graded Cycling Test with Talk Test is a submaximal exercise test independent of heart rate variability, shown reliable for patients with cardiac disease.

METHODS: Patients diagnosed with lacunar stroke according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria performed an incremental exercise test on a stationary bicycle with a 15 W (watt) increase in workload every minute. Toward the end of each incremental step, the patients recited a standardized text passage and subsequently were asked: "Are you still able to speak comfortably?" The test was stopped when the patients were no longer able to speak comfortably. Two consecutive tests were performed separated by 1 hour rest.

RESULTS: Sixty patients completed the study. The intraclass correlation coefficient (ICC2.1) was as follows: .97 [95% CI: .95-.98] with only a minor measurement error: 12.9 W for groups of patients (standard error of measurement, SEM95) and 18.3 W for individual patients (smallest real difference).

CONCLUSION: The "Graded Cycling Test with Talk Test" is feasible and reliable for monitoring exercise effects in patients with lacunar stroke. The high ICC2.1and small measurement error suggest it to be a valuable outcome measurement in clinical practice.

Original language	English
Journal	Journal of Stroke & Cerebrovascular Diseases
Volume	26
Issue number	3
Pages (from-to)	494-499
Number of pages	6
ISSN	1052-3057
DOIs	https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.12.004
Publication status	Published - 1 Mar 2017

Keywords

Adult
Aged
Aged, 80 and over
Analysis of Variance
Exercise Therapy/methods
Female
Heart Rate/physiology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Monitoring, Physiologic
Outcome Assessment (Health Care)
Retrospective Studies
Stroke/diagnostic imaging
Stroke Rehabilitation
Tomography Scanners, X-Ray Computed

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10.1016/j.jstrokecerebrovasdis.2016.12.004

Cite this

"Graded Cycling Test with Talk Test" Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke. / Steen Krawcyk, Rikke; Vinther, Anders; Caesar Petersen, Nicolas et al.
In: Journal of Stroke & Cerebrovascular Diseases, Vol. 26, No. 3, 01.03.2017, p. 494-499.

Research output: Contribution to journal › Journal article › Research › peer-review

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abstract = "BACKGROUND: Physical exercise is generally recommended as part of life style changes post stroke. Monitoring cardiovascular effects may help motivate patients for further exercise, and can be an instrument to assess intervention effects in clinical trials. In 1 of 4 stroke patients, the heart rate variability may challenge currently used cardiovascular monitoring. The Graded Cycling Test with Talk Test is a submaximal exercise test independent of heart rate variability, shown reliable for patients with cardiac disease.METHODS: Patients diagnosed with lacunar stroke according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria performed an incremental exercise test on a stationary bicycle with a 15 W (watt) increase in workload every minute. Toward the end of each incremental step, the patients recited a standardized text passage and subsequently were asked: {"}Are you still able to speak comfortably?{"} The test was stopped when the patients were no longer able to speak comfortably. Two consecutive tests were performed separated by 1 hour rest.RESULTS: Sixty patients completed the study. The intraclass correlation coefficient (ICC2.1) was as follows: .97 [95% CI: .95-.98] with only a minor measurement error: 12.9 W for groups of patients (standard error of measurement, SEM95) and 18.3 W for individual patients (smallest real difference).CONCLUSION: The {"}Graded Cycling Test with Talk Test{"} is feasible and reliable for monitoring exercise effects in patients with lacunar stroke. The high ICC2.1and small measurement error suggest it to be a valuable outcome measurement in clinical practice.",

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author = "{Steen Krawcyk}, Rikke and Anders Vinther and {Caesar Petersen}, Nicolas and Christina Kruuse",

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doi = "10.1016/j.jstrokecerebrovasdis.2016.12.004",

language = "English",

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N2 - BACKGROUND: Physical exercise is generally recommended as part of life style changes post stroke. Monitoring cardiovascular effects may help motivate patients for further exercise, and can be an instrument to assess intervention effects in clinical trials. In 1 of 4 stroke patients, the heart rate variability may challenge currently used cardiovascular monitoring. The Graded Cycling Test with Talk Test is a submaximal exercise test independent of heart rate variability, shown reliable for patients with cardiac disease.METHODS: Patients diagnosed with lacunar stroke according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria performed an incremental exercise test on a stationary bicycle with a 15 W (watt) increase in workload every minute. Toward the end of each incremental step, the patients recited a standardized text passage and subsequently were asked: "Are you still able to speak comfortably?" The test was stopped when the patients were no longer able to speak comfortably. Two consecutive tests were performed separated by 1 hour rest.RESULTS: Sixty patients completed the study. The intraclass correlation coefficient (ICC2.1) was as follows: .97 [95% CI: .95-.98] with only a minor measurement error: 12.9 W for groups of patients (standard error of measurement, SEM95) and 18.3 W for individual patients (smallest real difference).CONCLUSION: The "Graded Cycling Test with Talk Test" is feasible and reliable for monitoring exercise effects in patients with lacunar stroke. The high ICC2.1and small measurement error suggest it to be a valuable outcome measurement in clinical practice.

AB - BACKGROUND: Physical exercise is generally recommended as part of life style changes post stroke. Monitoring cardiovascular effects may help motivate patients for further exercise, and can be an instrument to assess intervention effects in clinical trials. In 1 of 4 stroke patients, the heart rate variability may challenge currently used cardiovascular monitoring. The Graded Cycling Test with Talk Test is a submaximal exercise test independent of heart rate variability, shown reliable for patients with cardiac disease.METHODS: Patients diagnosed with lacunar stroke according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria performed an incremental exercise test on a stationary bicycle with a 15 W (watt) increase in workload every minute. Toward the end of each incremental step, the patients recited a standardized text passage and subsequently were asked: "Are you still able to speak comfortably?" The test was stopped when the patients were no longer able to speak comfortably. Two consecutive tests were performed separated by 1 hour rest.RESULTS: Sixty patients completed the study. The intraclass correlation coefficient (ICC2.1) was as follows: .97 [95% CI: .95-.98] with only a minor measurement error: 12.9 W for groups of patients (standard error of measurement, SEM95) and 18.3 W for individual patients (smallest real difference).CONCLUSION: The "Graded Cycling Test with Talk Test" is feasible and reliable for monitoring exercise effects in patients with lacunar stroke. The high ICC2.1and small measurement error suggest it to be a valuable outcome measurement in clinical practice.

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KW - Middle Aged

KW - Monitoring, Physiologic

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KW - Retrospective Studies

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JO - Journal of Stroke & Cerebrovascular Diseases

JF - Journal of Stroke & Cerebrovascular Diseases

IS - 3

ER -

"Graded Cycling Test with Talk Test" Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke

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